The Clinical Effect of Dietary Supplementation with Omega-3 Fish Oils and/or Copper in Systemic Lupus Erythematosus

EMEIR M. DUFFY, GARY K. MEENAGH, STANLEY A. McMILLAN, JOHN J. STRAIN, BERNADETTE M. HANNIGAN, and AUBREY L. BELL

ABSTRACT.  

Objective. To determine the effect of dietary supplementation with omega-3 fish oils with or without copper on disease activity in systemic lupus erythematosus (SLE). Fish oil supplementation has a beneficial effect on murine models of SLE, while exogenous copper can decrease the formation of lupus erythematosus cells in rats with a hydralazine-induced collagen disease.

Methods. A double blind, double placebo controlled factorial trial was performed on 52 patients with SLE. Patients were randomly assigned to 4 treatment groups. Physiological doses of omega-3 fish oils and copper readily obtainable by dietary means were used. One group received 3 g MaxEPA and 3 mg copper, another 3 g MaxEPA and placebo copper, another 3 mg copper and placebo fish oil, and the fourth group received both placebo capsules. Serial measurements of disease activity using the revised Systemic Lupus Activity Measure (SLAM-R) and peripheral blood samples for routine hematological, biochemical, and immunological indices were taken at baseline, 6, 12, and 24 weeks.

Results. There was a significant decline in SLAM-R score from 6.12 to 4.69 (p < 0.05) in those subjects taking fish oil compared to placebo. No significant effect on SLAM-R was observed in subjects taking copper. Laboratory variables were unaffected by either intervention.

Conclusion. In the management of SLE, dietary supplementation with fish oil may be beneficial in modifying symptomatic disease activity. (J Rheumatol 2004;31:1551-6)

Key Indexing Terms:

SYSTEMIC LUPUS ERYTHEMATOSUS
FISH OIL
COPPER
REVISED SYSTEMIC LUPUS DISEASE ACTIVITY MEASURE
BENZYLAMINE OXIDASE

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From the Northern Ireland Center for Food and Health (NICHE), School of Biomedical Sciences, University of Ulster, Ulster; Musculoskeletal Education and Research Unit, Musgrave Park Hospital, Queens University, Belfast; and the Regional Immunology Service, Royal Victoria Hospital, Belfast, Northern Ireland.

E.M. Duffy, MLSc, BSc, PhD, NICHE, School of Biomedical Sciences, University of Ulster; G.K. Meenagh, MB, MRCP, Musculoskeletal Education and Research Unit, Musgrave Park Hospital, Queens University Belfast; S.A. McMillan, BSc, PhD, FRCPath, Regional Immunology Service, Royal Victoria Hospital; J.J. Strain, BSc, BAgr, PhD, Dip Ed; B.M. Hannigan, BA(Mod), PhD, FIBMS, NICHE, School of Biomedical Sciences, University of Ulster School of Biomedical Sciences; A.L. Bell, MD, FRCP, Musculoskeletal Education and Research Unit, Musgrave Park Hospital, Queens University Belfast.

Address reprint requests to Dr. A.L. Bell, Musculoskeletal Education and Research Unit, Department of Rheumatology, Musgrave Park Hospital, Stockmans Lane, Belfast, Northern Ireland BT9 7JB, UK. E-mail: a.bell@qub.ac.uk

Submitted March 13, 2003; revision accepted February 18, 2004.

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